Pills, thrills, and bellyaches
BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7488.0-h (Published 17 February 2005) Cite this as: BMJ 2005;330:0-h
All rapid responses
Peter Morrell discussed the apparent decline in rapid responses over
the past few years and I would like to add to his theories with the
reasons that I stopped responding (and am back… for now).
First and foremost was that after making even the most innocuous
posts I would receive a number of derogatory emails from people with
opposing views (at best rude, at worst hate-mail). Of course I don’t mind
debate, because that’s why we’re here after all, but I didn’t enjoy that
sinking feeling that would come when I opened up my email every morning.
Thus I’ve really welcomed the move to no longer post email addresses – if
you would like to respond to a comment I don’t see why you can’t do it on
the site.
The second reason for my personal decline in responding was that I
don’t have any desire to be in a slanging match, and I’m not terribly keen
on watching one either. Debate is good, interesting and enjoyable. But
personal insults, sarcasm and general rudeness is childish and uninviting.
I’m probably naïve, but I would have thought that a bunch of intelligent
adults could behave as such, without resorting to squabbling, petty
insults and in-fighting.
(I apologise in advance to all the people I’ve offended, but this is
something I’ve been feeling for a long time)
Competing interests:
None declared
Competing interests: No competing interests
I have just read Dr Smith's ideas for restricting "bores on the web"
and I think many BMJ readers will agree with most of the ideas. Many of
the rapid responses posted are of no interest to 99% of BMJ subscribers,
being posted by lay campaigners on one or two topics repeating the same
sentiments again and again.
Competing interests:
I don't know much about rocks
Competing interests: No competing interests
I admire Peter Morrell's analytical skills. I hope the BMJ will take
his constructive remarks in the right spirit.The BMJ's declining
popularity might also be because disaffected BMA-members are less inclined
to visit a journal owned by the same organisation.As for 'attacking'(in
writing), it was the former editor, Dr Smith, who was in the forefront
rather than Peter Morrell.For an example, many
will remember Dr Smith's intemperate oubursts in his response titled
"Bores on the web" which were apparently aimed at a few including myself,
which landed him in court at great expense and trouble to his then
employer,the BMA.
Competing interests:
See Text
Competing interests: No competing interests
Decline of BMJ
Mark Struthers claims my figures contain a distortion due to his
postings about the Middle East: and that this "will most certainly have
skewed the figures on rational responding," [1] and that this "must surely
account for the massive decline in BMJ activity since the beginning of
this year. I can’t see that charging for access is a good idea either."
[1] I agree that using the search engine figures provide an only crude
figure of BMJ activity. But it must show 'something'...a something that
has stayed steady in 1999-2003 and has then declined since last July. I
think many ups and downs in the year can have distorted the figures, but
these would tend to cancel each other out over time. The data may contain
many distortions and do not also forget the impact of the censorship
issue…more rapid responses must have been received since September that
were not posted due to them being defamatory or offensive in some way.
This policy must have contributed something to the observed ‘decline.’ It
is hard to quantify this aspect.
Herbert Nehrlich claims I "(and others) attacked Richard Smith when
he was editor. Now you attack him for saying that things are better since
he has left.” [2] That is not strictly true. I did not ‘attack’ him…how
could I? I would not even know who he was if he rode past me on his
bicycle, let alone attack him.
What I did was to criticise him when he published a disgraceful
obituary to David Horrobin and then compounded his error by refusing to
retract or amend it, and refusing to apologise for the upset he had caused
to the Horrobin family. Then he continued to pay the same person to write
further BMJ obituaries. I was not alone in thinking that such a gross
error of judgement was and is unforgivable.
Nor do the criticisms I have recently made are said because he has
gone, because he is a living being called ‘Richard Smith’ or because he
was once BMJ editor. They are made simply and solely because the comment
he made seemed woefully inappropriate, if not downright inaccurate. And
here below are the figures to support my point.
Here is a summary of the search engine figures:
|
Year |
Mean items per month |
% of 2002 |
|
1999 |
198.75 |
81.39932 |
|
2000 |
237.6667 |
97.33788 |
|
2001 |
239.5833 |
98.12287 |
|
2002 |
244.1667 |
100 |
|
2003 |
216.75 |
88.77133 |
|
2004 |
182 |
74.53925 |
|
Mean |
219.8194 |
90.02842 |
What this data shows is that compared to the years 2000-2002, then
2003 and 2004 are below par and the gap seems to be widening.
Here is a second table showing further data from the search engine
info:
| Month/year | Search engine data | 1999-2003 monthly mean |
% downturn | |||
|
Jun-04 |
205 |
231.8333 |
11.57441 |
|||
|
Jul-04 |
187 |
215.1667 |
13.09063 |
|||
|
Aug-04 |
146 |
177.5 |
17.74648 |
|||
|
Sep-04 |
145 |
206 |
29.61165 |
|||
|
Oct-04 |
156 |
203.6667 |
23.40426 |
|||
|
Nov-04 |
81 |
179 |
54.7486 |
|||
|
Dec-04 |
118 |
225.5 |
47.67184 |
|||
|
Jan-05 |
82 |
224.3333 |
63.44725 |
|||
|
Feb-05 |
30 |
188.6667 |
84.09894 |
|||
What this data shows is that overall ‘BMJ activity’ has been
declining since June 2004 to the tune of first 10-20% [June to August] of
the 1999-2003 averages, then to 20-30% [Sept and Oct] and more recently by
50-84% [November to Feb].
Here is the corresponding data for recent rapid responses:
|
Month/year |
Mean rapid |
% of Nov 04 |
Downturn as % of Nov 04 |
|
Oct-04 |
4.55 |
100% |
0 |
|
Nov-04 |
4.26 |
93.62637 |
6.373626 |
|
Dec-04 |
4.117356253 |
90.49135 |
9.508654 |
|
Jan-05 |
1.698038022 |
37.31952 |
62.68048 |
|
Feb-05 |
1.406749079 |
30.91756 |
69.08244 |
This table shows that the number of rapid responses per article, in
each of the months shown, has declined from 4.55 in November to around 1.4
this month. This in turn represents about 30% of the November amount and
hence a 69% reduction in the BMJ rapid responses since that date. The
additional fact that for January 2005 the percentage reduction in rapid
responses [62.68%] matches almost exactly the percentage reduction shown
by the search engine data [63.44%] illustrates that something real is
being measured by these figures and that something is in steep decline.
I have provisionally suggested that the cause of this reduction is
the unilaterally introduced removal of email addresses from the site
[since October] and the ‘pay to view’ decision for articles from January
onwards. The data certainly supports such a view. The biggest drop has
been since December and hence it seems safe to conclude that it is the
‘pay to view’ policy that is the bigger of those two possible causes.
Whether it is the whole truth of the matter is, however, for others to
judge.
Several people have called for the email addresses to be put back on
the site and some also for the ‘pay to view’ policy to be reconsidered or
rescinded. If BMJ wishes to recover its steep collapse in popularity then
it might well be advised to seriously consider reviewing these recently
introduced changes to the site, which appear to be losing the journal the
support of the worldwide web-browsing public.
Sources
[1] Mark Struthers, Thrills, spills and happy pills 25 February 2005
[2] Dr. Herbert H. Nehrlich, Objection, Your Honour ! 25 February
2005
Competing interests:
None declared
Competing interests: No competing interests
Yes Peter, he could have been more wrong.
While I do not agree with some of the policies that have been implemented
by the BMJ as of late, I must say that even a cursory look at ALL other
medical publications will show you that the baby has not been thrown out
with the bathwater.
I remember clearly how you (and others) attacked Richard Smith when
he was editor. Now you attack him for saying that things are better since
he has left.
I do not (and I have said so repeatedly) like the most ridiculous
censorship on the e-mail addresses of the individual writers, I am not in
favour of paying for something that I previously could get for free and,
last but most certainly least, I am quite sick and tired of finding the
same names, re-hashing the same old stuff, akin to whipping a very dead
and tired (in that order) horse, again and again.
Overall, however, what are the glaring faults of the "new" BMJ?
Is the number of posts indicative of some kind of "acceptance", of
quality or relevance among rivals?
I have felt no undue restrictions since Richard Smith left,
and I still count the BMJ as my favourite journal.
After all, my wife isn't all she once was anymore, either.
Competing interests:
None declared
Competing interests: No competing interests
Peter Morrell should not forget that October through December last,
the BMJ indulged very heavily in peacekeeping operations in the Middle
East - at the instigation of London psychiatrist Dr Derek Summerfield and
with Leeds GP Dr Simon Fellerman to add some balance to the debate. This
bizarre activity will most certainly have skewed the figures on rational
responding.
I have personally long been keen to keep my end up and reinforce the
BMJ rapid response tally. However, during the prolonged Israel/Palestine
intifada, my responses were deemed to be ‘fouling up the website like rank
weeds’. Ever since, I have found postings an increasingly uphill struggle.
These two events must surely account for the massive decline in BMJ
activity since the beginning of this year. I can’t see that charging for
access is a good idea either.
Competing interests:
None declared
Competing interests: No competing interests
When Richard Smith said: "everybody I speak to says that the journal
is better," [1] there are those who would not be surprised to find just
how wrong he is...he could not have been MORE wrong.
There are those who regard "the restrictions on access to the BMJ are
a major problem. I appreciate the business arguments for your decision but
I feel very strongly that they are regressive and in the long run
counterproductive." [2] And, touchingly, there are still those who love
BMJ very deeply: "Perhaps without being aware of it, the BMJ, through its
open access and general attitude toward making information available, is
doing a tremendously important service, a genuine public service." [3]
Open access? Not since January…
Now over to the facts!
In the past 2 months I have been collecting data on the rapid
responses and watching its massive decline compared to the
October/November figures. It is only a whopping 70% drop!! Therefore, it
is quite absurd to say "everybody I speak to says that the journal is
better." [1] It is in fact the voice of an ostrich. The journal is worse,
far worse than many readers imagine.
Not only has the number and average of rapid responses tumbled
massively since last year, but the amount of what I call 'BMJ activity'*
has also collapsed by roughly the same amount from 230-240 per month for
the past 5 years to only 80 or so for December and January—a drop of about
two thirds. At 82 items, January 2005 is 63.5% down on the 2000-2003
average. This massive decline started in 2003 but has continued through
2004 and most especially since July 2004, since which time it has run
downhill.
Throughout January and February 2005 the average rapid response per
article has been running at between 1 and 1.5 compared with figures like
3.9 to 4.5 in October, November and December. The average of current
"rapid response per article" as a percentage of November averages is
running at between 22 and 39% for the whole of January and February, and
is persistently in the 28-29% bracket for this entire 8 week period. That
is some drop.
I would suggest that these are quite shocking figures, and that the
BMJ ought to ponder long and hard on the likely reasons behind them. By
stopping unpaid open access to articles, a policy announced in October,
unilaterally and without any warning or consultation, people have simply
stopped visiting the site or have stopped responding to articles they
cannot read anyway. I cannot think of any other reason that would cause
this massive collapse of readership and usefulness of the journal.
If BMJ wishes to publish the entire tracking details, I can send it
in, not that it makes very joyful reading.
Sources
[1] Richard Smith, Great news for the BMJ and the BMJ Publishing
Group, 11 Feb 2005
[2] Harry Rutter, Please reconsider, 24 February 2005
[3] Dr. Herbert H. Nehrlich, Re: PILLS THRILL BUT COULD KILL, 19 Feb
2005
* BMJ activity is the total number of all publications listed by the
search engine for any month you enter. For example, if you type in July
2000 you get 252; if you type in July 2004 you get 187, and so on. It
includes both articles and rapid responses. Tracking of this figure for
each month for the last five years reveals a recent and massive decline
since about last July.
Competing interests:
None declared
Competing interests: No competing interests
Maybe there is so little "street trade" because it is so easy to go
to a physician, answer a series of questions, get a diagnosis, and walk
out with a prescription. And on top of that, insurance will pay for it.
Speaking of slanted lanquage, there is little proof that depression is a
"disease" in the typical sense. When I ask psychiatrists and researchers
to provide evidence for a biological basis of disease they usually provide
a citation to a textbook or review articles. Maybe Dr. Klein could
provide a short list of research papers that he thinks are the best
evidence supporting the biological theory (or theories) of mental illness.
Competing interests:
None declared
Competing interests: No competing interests
Since retirement from the hurley burley of Emergency Medicine I have
been helping with substance misusers in a prison. I hate to disappoint
Professor Klein but 'trips' (amitryptiline) trade well in prison - but
then I suppose other illicit substances are less available.
Competing interests:
None declared
Competing interests: No competing interests
Re: Re: Decline of BMJ...more
Like Samantha
Line, I dreaded the hate mail that I'd receive after submitting rapid responses. The hate mail hasn't stopped since e-mail addresses were removed from our postings (I suppose the hate mailers have us in their address books), but it has slowed down.
When Mark Struthers says that fear of harassment has kept some "girlie-men" away he seems to be referring just to doctors, but this is an odd label.
Quackwatch.com has a page for "cheers and jeers". After reading the "jeers", a psychology professor "became concerned that emotional dyscontrol, scatalogia, and a precipitous decline in general IQ may be heretofore unrecognized side effects of homeopathy, chiropractic therapy, herbalism, and the like". The professor
suggested that someone look into this. So, how about the BMJ helping with this much-needed study?
The findings could be published in your Christmas edition.
Competing interests:
None declared
Competing interests: No competing interests